Self–rated Health Status of U.S. Immigrants: Does Language Preference Matter?

A number of studies that employ self-rated health among ethnic/immigrant groups in the U.S. have questioned the predictive validity of SRH, showing that the less acculturated and non-English speaking immigrants tend to report lower health status compared to more acculturated immigrants or the native-born. To our knowledge, studies exploring how language, as a measure of acculturation, influences responses to SRH among immigrants in the U.S. have been limited to one ethnic/racial group or a single geographic area. In this paper, we utilized the 2003 New Immigrant Survey (NIS) of 8,573 new permanent legal residents in the U.S to examine associations between language and SRH for immigrants who come from the major sending countries/regions. We constructed six immigrant-language groups and compared those who responded to the NIS questionnaire in English to those who responded in a non-English language, namely Chinese, Russian, or Spanish. We conducted bivariate analyses for each of the three constructed language-immigrant groups to estimate the associations between language preference and reporting fair/poor health. Our findings revealed strong statistical associations, with a higher proportion of immigrants who responded to the NIS in Spanish, Chinese, or Russian reporting fair/poor health compared to those who responded in English. In the paper, we draw on the literature on immigrant health and point to the importance of considering language preference/facility when studying the health of immigrants using subjective measures. We discuss policy implications for health care delivery to non-English speaking immigrants in the U.S.